A completed application includes the following items.
1. 2. 3. 4. 5. 6. 7. 8. 9. Completed CBRF Initial License Application (F-60287) Background check completed by Office of Caregiver Quality on the licensee and all non-residents age 10 and older. Floor plan. DHS 83.05(2)(b) A licensing fee of $306, plus $39.60 per resident based on capacity of facility. NOTE: For a PROBATIONARY LICENSE, the fee for 12 months is 1/2 this amount. Evidence of financial ability to operate for 60 days. DHS 83.05(2)(f) Balance sheet. DHS 83.05(2)(e) Program statement. DHS 83.05(2)(a) Fire inspection. DHS 83.05(2)(c) The Department (DHS) has received a response to the hazard request from the municipality or thirty (30) days have elapsed since DHS sent the hazard request to the municipality.

B. The following items will be requested or may be reviewed on-site.
1. 2. 3. 4. 5. 6. 7. 8. 9. Emergency plan. DHS 83.47(2) Admission agreement. DHS 83.29 Community Advisory Committee documentation. DHS 83.05(3) and Chapter 50.03(4)(g), Wis. Stats. Resident rights, house rules policy. DHS 83.32 Grievance procedure. DHS 83.33 Evidence of site approval if the land is zoned for commercial, industrial, or manufacturing use. Approval by the Department of Natural Resources where a public water supply is not available. Documentation of approval of building plans by DHS and/or Dept. of Commerce. Documentation of final inspection of the building by DHS and/or Dept. of Commerce.

10. Documentation of sprinkler plan approval for new construction or documentation of sprinkler system inspection for existing buildings. 11. Documentation of smoke and heat detection system compliance.